Leading from the front

A self-styled crusader for dementia care, in May, Bisiani addressed the prestigious
25th Annual Gerontology Association conference in Canada.

The only Australian speaker, she outlined the changes she has introduced as manager of Thornbury Aged Care hostel, Primelife Medina Manor, in Melbourne. These include alternative therapies such as aromatherapy, massage, music and yoga, designed to reduce boredom and alleviate the frustration and loneliness associated with dementia.

While her main presentation was on ‘Get Wet for Wellbeing’ – on methods of ensuring residents don’t suffer from dehydration, and the associated problems of UTIs, falls, incontinence and acute delirium, Bisiani says she went to network with other aged care professionals and to learn new strategies.

While she did lots of networking, “I was disappointed, in fact shocked, to find out how far behind Australia Canada is – dramatically behind.

“There were no presentations that excited me, or gave me new information. It was very disappointing. The topics they were talking about we had covered 10-15 years ago.

“I met lots of interesting people dedicated to providing quality aged care, and frustrated because there is no government assistance, so only the rich can afford care.”

Bisiani said the situation in Canada is reminiscent of the state of aged care in Australia 15 years ago. Because there is no government funding, no accreditation, no auditing, aged care providers cannot implement programs, other than in individual homes. There is as yet no unified push by other health professionals working with aged care providers to demand government funding.

“They are where we were 15 years ago, before accreditation, auditing, RCS assessment and care planning. Providers are excited by the prospect of providing quality care and frustrated that they can’t do it for lack of resources. With no government funding, most Canadians simply can’t afford aged care. What happens when the baby boomers age – there’ll be nowhere for them to go.”

Bisiani says she felt “immensely proud about what we have achieved in Australia, especially in training staff and teaching other healthcare professionals.”

When she described all the complementary therapies on offer to the residents with dementia living at Thornbury hostel, her listeners must have thought she was describing a fantasy land.

Talking to facility managers, nurses, doctors, professors of gerontology and social workers, she saw “an abysmal lack of knowledge of dementia care.” They seemed to have “a very basic knowledge of dementia care,” and some of the facilities she saw or heard about “were archaic.”

“General understanding about dementia was pretty much nil. Some people had a broad knowledge, but not an understanding of the different types of dementia, nor how dementia affects each individual differently. They had the view that everyone with dementia required the same care. They were not familiar with the concept of person-centred care, or of dementia-specific facilities.”

Disappointed by the lack of new information, Bisiani says what she gained from the conference was “validation that we are on the right track in Australia and leading the way ahead. I felt fantastic about that – very proud about how progressive we are.

“Sure we could do better, we could always do better, and some people are still missing out. But we are doing an absolutely fabulous job. The rest of the world recognises that we’re leading the way. The Canadians were saying to me, ‘Australia, we can learn so much from you.'”


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